I am applying for a second five-year K05 Established Investigator Award to allow me to continue my cancer research agenda and to provide time for mentoring junior colleagues. The renewal application documents the degree to which the initial Award enabled me to succeed in each of these areas, and the specific ways in which support for five additional years would be put to use. The K05 renewal will allow me: 1) to reduce my current clinical and administrative duties by 50% FTE so that I can develop and refine my research into the accuracy and outcomes of cancer screening and diagnosis;and 2) to engage junior investigators in clinical studies and train them to conduct independent research. The ultimate goal of my own research is to improve cancer screening, detection, and care. I propose working with trainees on clinically significant and innovative projects in three areas: 1. Studies examining variability among pathologists in the interpretation of breast tissue and the impact of digital imaging technology and double reading by pathologist on interpretive performance. 2. Qualitative studies of physicians'attitudes and experiences communicating errors in medical diagnoses. 3. Studies of radiologist characteristics associated with the accuracy of diagnostic mammography. In terms of mentoring, I will continue the commitment I have made in the initial five years of K05 funding to mentor a diverse group of junior investigators who are planning or engaged in cancer-related clinical studies. Based on my experience to date, the trainees will be located both inside and outside of the University of Washington. I enjoy research and mentoring and look forward to doing more in the next five years. PUBLIC HEALTH RELEVANCE: This award will support protected time for Dr. Elmore to expand her clinical research program and continue mentoring junior investigators in the areas of cancer detection, diagnosis, and outcomes. Specifically, junior investigators will be mentored on projects in general epidemiology, cancer screening and diagnosis, and the role of technology in cancer care.